Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study.


Journal

Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173

Informations de publication

Date de publication:
01 03 2020
Historique:
received: 31 08 2019
revised: 07 12 2019
accepted: 22 12 2019
pubmed: 7 2 2020
medline: 22 6 2021
entrez: 7 2 2020
Statut: ppublish

Résumé

The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.

Sections du résumé

BACKGROUND
The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander.
METHODS
This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge.
RESULTS
All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively).
CONCLUSION
In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.

Identifiants

pubmed: 32027980
pii: S0300-9572(20)30046-0
doi: 10.1016/j.resuscitation.2019.12.042
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

218-226

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Jan-Thorsten Gräsner (JT)

University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University-Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Kiel, Germany. Electronic address: jan-thorsten.graesner@uksh.de.

Jan Wnent (J)

University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University-Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Kiel, Germany; University of Namibia, School of Medicine, Windhoek, Namibia.

Johan Herlitz (J)

Prehospen-Centre for Prehospital Research, Faculty of Caring Science, Work-Life and Social Welfare, University of Borås, Borås, Sweden.

Gavin D Perkins (GD)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom; University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Rolf Lefering (R)

Institut Für Forschung in Der Operativen Medizin (IFOM), Abteilung Statistik Und Registerforschung, Universität Witten/Herdecke, Germany.

Ingvild Tjelmeland (I)

Oslo University Hospital, Division of Prehospital Services, Norway; University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany.

Rudolph W Koster (RW)

Department of Cardiology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, The Netherlands.

Siobhán Masterson (S)

Discipline of General Practice, National University of Ireland Galway (on Behalf of the Out-of-Hospital Cardiac Arrest Register (OHCAR)) and the HSE National Ambulance Service, Ireland.

Fernando Rossell-Ortiz (F)

Empresa Pública de Emergencias Sanitarias de Andalucía, Spain.

Holger Maurer (H)

University Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Lübeck, Germany.

Bernd W Böttiger (BW)

Professor and Head of the Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany; European Resuscitation Council (ERC), Niel, Belgium.

Maximilian Moertl (M)

Department of Anaesthesia and Intensive Care, Universitätsklinik Innsbruck, Innsbruck, Austria.

Pierre Mols (P)

Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Belgium.

Hajriz Alihodžić (H)

Emergency Medical Service, Public Institution Health Centre 'Dr. Mustafa Šehović' and Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.

Irzal Hadžibegović (I)

University Hospital Dubrava Zagreb, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University Osijek, Croatia.

Marios Ioannides (M)

Nicosia General Hospital, Cyprus.

Anatolij Truhlář (A)

Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic.

Mads Wissenberg (M)

Emergency Medical Services Copenhagen, University of Copenhagen, Denmark.

Ari Salo (A)

Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Josephine Escutnaire (J)

Univ. Lille, CHU Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, F-59000 Lille, France.

Nikolaos Nikolaou (N)

Cardiology Department and ICCU, Konstantopouleio General Hospital, Athens, Greece.

Eniko Nagy (E)

Hungarian Resuscitation Council, Emergency Department University of Szeged, Hungary.

Bergthor Steinn Jonsson (BS)

Department of Emergency Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Peter Wright (P)

HSE National Ambulance Service and National University of Ireland Galway, Ireland.

Federico Semeraro (F)

Department of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, Bologna, Italy.

Carlo Clarens (C)

Secretary of Luxembourg Resuscitation Council, Luxembourg.

Steffie Beesems (S)

Amsterdam UMC, Academic Medical Center, Heart Center, Department of Cardiology, Amsterdam, The Netherlands.

Grzegorz Cebula (G)

Jagiellonian University Medical College, Faculty of Medicine, Department of Medical Education, Poland.

Vitor H Correia (VH)

Emergency Medical Service - SEMER/EMIR, Funchal, Portugal.

Diana Cimpoesu (D)

University of Medicine and Pharmacy Gr.T. Popa Iasi, Emergency Department, Emergency County Hospital Sf. Spiridon, Iasi, Romania.

Violetta Raffay (V)

Serbian Resuscitation Council, Novi Sad, Serbia.

Stefan Trenkler (S)

P. J. Safarik University, Medical Faculty, L. Pasteur University Hospital, Department of Anaesthesiology and Intensive Medicine, Kosice, Slovakia.

Andrej Markota (A)

Medical Intensive Care Unit, University Medical Centre Maribor, Maribor, Slovenia; Slovenian Resuscitation Council, Slovenian Society for Emergency Medicine, Ljubljana, Slovenia.

Anneli Strömsöe (A)

Department of Prehospital Care, County Council of Dalarna, Falun, Sweden; Centre for Clinical Research, Falun, Dalarna, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.

Roman Burkart (R)

Interassociation of Rescue Services, Bern, Switzerland.

Scott Booth (S)

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.

Leo Bossaert (L)

University of Antwerp, Antwerp, Belgium; European Resuscitation Council (ERC), Niel, Belgium.

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